Prospective and Retrospective Review of Gynecologic Cytopathology: Findings From the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference Working Group 2

Brainard, Jennifer; Birdsong, George G.; Elsheikh, Tarik M.; Hartley, David A.; Naik, Kalyani; Neal, Margaret B.; Souers, Rhona J.; Henry, Michael R.

doi:10.5858/arpa.2012-0178-oa

Cited by 16 publications

(16 citation statements)

References 24 publications

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“…Las tasas oscilan entre el 0,3 y el 1% de las muestras, variando según el método de preparación utilizado 88 . Se sabe que con más frecuencia las muestras insatisfactorias provienen de pacientes con lesiones de alto riesgo cuando se comparan con un grupo control de muestras satisfactorias 193 .…”

Section: Fase Diagnósticaunclassified

“…Se considera como estándar de calidad el segundo cribado, prospectivo, llevado a cabo por un supervisor de citotécnicos o por un patólogo, de al menos un 10% de los casos negativos interpretados por cada citotécnico con citología convencional. Muchos laboratorios revisan porcentajes mayores (hasta un 30%) con el objetivo de garantizar un menor número de falsos negativos 193 . Los casos deben seleccionarse de manera aleatoria y han de incluir un porcentaje importante de casos de alto riesgo, así como citologías insatisfactorias.…”

Section: Programa De Control Interno De Calidadunclassified

“…La normativa estadounidense (Clinical Laboratory Improvement Amendments, CLIA 88) requiere también el doble cribado retrospectivo de las citologías de los últimos 5 años en pacientes con HSIL+ 193 . Esta práctica no suele afectar al manejo del paciente y se considera indispensable para la monitorización de la calidad del centro y con fines formativos.…”

Section: -Revisión De Todas Las Muestras Citológicas Previas En Casosunclassified

“…Las revisiones de cribado compartidas entre varios laboratorios se realizan en diferentes países, y es un modo de mejorar la tasa de falsos negativos en el cribado primario. Se utiliza ocasionalmente como alternativa al doble cribado del 10% de la muestra 193 .…”

Section: Evaluación Externa De La Calidadunclassified

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Guía de cribado del cáncer de cuello de útero en España, 2014

Bladé

Saladrigues

Gimferrer³

et al. 2014

Progresos de Obstetricia y Ginecología

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Justificación de la Guía de cribado del cáncer de cuello de útero en España, 2014El cáncer de cuello uterino (CCU) es la tercera neoplasia más frecuente en el mundo en las mujeres. El cribado de mujeres sanas mediante citología cervical ha demostrado claramente su eficacia, puesto que su aplicación de forma adecuada y sistemática en determinados paí-ses ha conseguido reducir en un 70-80% la incidencia y mortalidad por CCU. Este beneficio se debe a la detección de lesiones premalignas asintomáticas cuyo diagnóstico y tratamiento evita su progresión a carcinoma invasor.En las dos últimas décadas, múltiples estudios han aportado una só-lida evidencia que confirma al virus del papiloma humano (VPH) como agente causal de la práctica totalidad de los casos de CCU y de sus lesiones precursoras. Un número limitado de genotipos de VPH de alto riesgo oncogénico (VPH-AR) está causalmente implicado. Concretamente, los VPH 16 y 18 explican el 70% de los CCU y otros 10 tipos (VPH 45,31,33,52,58,35,59, 56, 51 y 39) explican el 25-35% de los casos restantes. Esta información ha permitido establecer un nuevo modelo de carcinogénesis basado en la persistencia de la infección por VPH como elemento necesario para el desarrollo de lesiones precursoras y CCU. Sin embargo, más del 90% de las infecciones por VPH son transitorias y, por tanto, irrelevantes desde el punto de vista oncogénico. Durante los primeros años de vida sexual se observa una elevada incidencia de infección, pero la mayoría de estas infecciones son transitorias y desaparecen espontáneamente. Las mujeres mayores de 30 años experimentan una clara disminución de la prevalencia de la infección por VPH, pero un

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Section: Fase Diagnósticaunclassified

Section: Programa De Control Interno De Calidadunclassified

Section: -Revisión De Todas Las Muestras Citológicas Previas En Casosunclassified

Section: Evaluación Externa De La Calidadunclassified

See 2 more Smart Citations

Guía de cribado del cáncer de cuello de útero en España, 2014

Bladé

Saladrigues

Gimferrer³

et al. 2014

Progresos de Obstetricia y Ginecología

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“…Different strategies of cervical cytology quality control include random rescreening, a full review, rapid prescreening, double screening, and others [9][10][11][12] . The most widely used approach is a 10% random rescreening (R10), which is a mandatory internal quality control tool according to US CLIA '88 regulations [13] .…”

Section: Introductionmentioning

confidence: 99%

False-Negative Rate of Papanicolaou Testing: A National Survey from the Thai Society of Cytology

Koonmee

Bychkov

Shuangshoti³

et al. 2017

Acta Cytologica

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Objective: To evaluate the performance of Papanicolaou smear screening in Thailand at the national level, and to propose recommendations for continuing quality control. Study Design: This study was conducted by The Thai Society of Cytology and involved 124 laboratories in 76 provinces during 2010-2014. Random sampling suggested recalling of 10% of slides defined as negative at routine screenings (10% random rescreening [R10] model) directly from the reading unit. Results: Out of 330,075 smears covered by the rescreening project throughout its 5-year duration, the rates of abnormal, unsatisfactory, and normal results were 0.63, 1.82, and 97.55%, respectively. Abnormal findings were largely represented by ASC-US (54%) and L-SIL (21%). The average false-negative rate (FNR) measured at the level of L-SIL and higher was 13.8%. Conclusion: The national project was developed to address the accuracy of cervical cancer screening and to promote internal quality assurance based on the R10, on-site surveys, and education. The major output parameters of this study (FNR and number and distribution of abnormal cases on rescreening) improved significantly in the main phase of the project (2012-2014), after revising substantial logistics issues encountered during the first 2 years of this study. This project provided objective measurable evidence related to the quality of cytology-based cervical cancer screening in Thailand.

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Knowledge of the HPV status biases cytotechnologists' interpretation of Pap tests originally diagnosed as negative for intraepithelial lesion or malignancy

Doxtader

Brainard

Underwood

et al. 2016

Cancer Cytopathology

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BACKGROUND: Because of cervical cancer screening recommendations and forthcoming first-line human papillomavirus (HPV) screening, many Papanicolaou (Pap) tests will be performed in patients with known concurrent HPV results. This study was designed to evaluate whether knowledge of the HPV status affects cytotechnologists' interpretation of Pap tests. METHODS:A retrospective search of cervical screening Pap tests with known concurrent HPV results provided 250 ThinPrep Pap tests, which were chosen to reflect an atypical rate similar to the rate of the Cleveland Clinic's normal practice.Fifty percent of negative for intraepithelial lesion or malignancy (NILM) and atypical squamous cells of undetermined significance (ASCUS) cases were from patients with positive HPV results. Slides were re-evaluated twice by 8 cytotechnologists blinded to the diagnosis and study purpose. The HPV status was provided for 50% of the cases in the first phase; after a washout period, knowledge of the HPV status for each case was reversed in the second phase. Follow-up information was collected from the medical record. RESULTS: In both phases, there was a significant bias for HPV-positive NILM cases to be upgraded to ASCUS or worse when the HPV-positive status was provided (P <.001). When the HPV status was withheld, there was no difference in upgrading NILM cases (phase 1, P 5.69; phase 2, P 5.066). A combined analysis showed a significant bias in referral to the pathologist when the HPV-positive status was provided rather than withheld (P <.001). Follow-up data revealed no significant effect of bias when the HPV-positive status was provided between patient groups with benign, low-grade, or high-grade follow-up. CONCLUSIONS: A known HPV-positive status biases cytotechnologists' interpretation of Pap tests, and this results in a higher rate of upgrading to ASCUS or worse; however, it does not improve sensitivity for disease detection. Cancer Cytopathol 2017;125:60-9.

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Prospective and Retrospective Review of Gynecologic Cytopathology: Findings From the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference Working Group 2

Cited by 16 publications

References 24 publications

Guía de cribado del cáncer de cuello de útero en España, 2014

Guía de cribado del cáncer de cuello de útero en España, 2014

False-Negative Rate of Papanicolaou Testing: A National Survey from the Thai Society of Cytology

Knowledge of the HPV status biases cytotechnologists' interpretation of Pap tests originally diagnosed as negative for intraepithelial lesion or malignancy

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